Individual Task Card for medical and non-medical staff: A tool for optimal resource utilisation. 2025
Sabina Karczmarz, Paweł Żuk, Marika Guzek, Anna Kordowska, Małgorzata Kalisz
Medical and Diagnostic Centre
Background. An optimal medical service provision plan relies on parameterising work through real-time or near-real-time data collection on medical and organisational tasks, alongside analysis of value creation – evaluating currently unavailable key process costs, life expectancy impact, and costs of redundant processes.
This process has been implemented for years at the Medical and Diagnostic Centre (MDC) in Poland, supported by data from hundreds of thousands of incidents and measurements of their quantifiable outcomes.
Aim of the Individual Task Cards. Enhanced Quality and Safety of Services. Enables detailed control of time spent on individual tasks, categorised by type and priority. Supports fulfilment of individual working time allocations, promoting accountability and efficiency. Prioritization of services-focus attention on key services by giving high priority (including higher financial rate) which encourages performance. Optimised Competency Utilisation. Performance-based incentives: Monthly bonuses are calculated based on completed tasks, linking remuneration to measurable output
Case report. Each service within the ITC system is assigned a defined time, priority, and monetary value. Procedures are further prioritized using a color-coded scheme, with red denoting services of highest importance. Employees are given monthly performance thresholds for red-priority procedures. Currently, 70–80% of services are recorded via ITCs. Full coverage (100%) applies to non-medical personnel, encompassing 331 staff members. The service catalogue includes 618 procedures. On average, 500,000 procedures are recorded monthly, serving 100,000 primary healthcare (PHC) patients annually, alongside 30,000 preventive contacts and 160,000 secondary healthcare (SHC) patients. As 70% of PHC services are documented by name in the system, it is possible to verify precisely who provided each service, where, to whom, and when
Conclusions. The use of ITCs can be implemented in other medical institutions, provided there is a commitment to improving service quality, patient safety, and staff remuneration.
The role of pharmaceutical services in rural areas in Poland.2025
Joanna Siennicka1, Jolanta Pańkowska1, Damian Chaciak1, Michał Żuk1, Paweł Żuk1, Joanna Oberska2, Magdalena Łoś1,2
1 Medical and Diagnostic Center, Siedlce, Poland; 2 Medical University in Warsaw, Poland
Background. The scope of pharmaceutical services in Poland remains limited. Despite the legal framework being in place since 2021, the practical application of expanded pharmacists’ competencies has not yet been fully realized in the Polish healthcare system. The role of pharmacists cooperating with PCPs could be even
more important in depopulation areas.
Aim of the study. The aim of the study was analysis of the role of pharmaceutical services in rural areas in Poland.
Methodology. A national survey was developed to assess attitudes towards increasing pharmacists role in patient care in Poland. The form was administered to pharmacists and primary care physicians. Responses collected between September 2024 and February 2025 were included in the analysis.
Results. Three hundred and five pharmacists’ and 118 PCPs’ responses were analysed. Pharmacists were more open and interested in fulfilling more roles in patient care and providing additional pharmaceutical care services. Highest support received identifying unnecessary medications (88.9%), patient education about new medications (85.6%) and identifying medication-related issues such as allergies, dosage, drug interactions, and potential for adverse effects (85.6%). In responses of primary care physicians identifying unnecessary medications (68.8%), training patients in the use of medical devices, e.g. inhaler or glucometer (59.3%) and identifying medication-related issues (55.9%) were the most popular. Pharmacists were also open to contribute to various aspects of patient care – performing vaccinations (58.7%), performing screening
tests in a pharmacy (50.5%), and scheduling referrals for preventive examinations (44.6%). Notably, 75.1% of pharmacists supported issuing continuation prescriptions, which could significantly improve medication access in rural areas, though only 29.7% of PCPs agreed.
Conclusions. The survey results highlight the potential for expanded pharmacist roles to address healthcare gaps in rural areas. Agreement on certain pharmacist roles provides a foundation for interprofessional collaboration between pharmacists and physicians. Extended pharmacist roles, patient education, issuing continuation
prescriptions, could significantly improve medication management and access in rural communities.
Health care in depopulation areas: Contemporary challenges related with population wellbeing and shortage of medical staff. 2025
Przemysław Dybciak1, Dorota Lenarcik1, Grzegorz Bańka1, Sabina Karczmarz1, Artur Prusaczyk1, Magdalena Łoś1,2
1 Medical and Diagnostic Center, Siedlce, Poland; 2 Medical University of Warsaw, Poland
Background. A noteworthy achievement of modern civilization is increasing life expectancy. However, the paradox results from the presence of a non-linear relationship between life expectancy and its quality. Longer life is relatively more often associated with poorer quality of health, which is reflected by an increasing burden of non-communicable chronic diseases in the population of industrialized countries. Insufficient satisfaction of health needs resulting from limited resources of medical staff, and contemporary age patterns inscribed in epidemiological parameters are the common denominator of current challenges to the health care system, as well as Polish and EU health policy. The above-mentioned challenges have become an inspiration for the research team to develop and implement a conceptual research model in the context of the phenomenon of medical deserts.
Aim of the study. The aim of the study was analysis of the phenomenon of medical deserts from a systemic perspective, with particular consideration of health aspects.
Methodology. Literature review concerning the phenomenon of medical deserts and career plans of future medical staff. Quantitative study using a questionnaire for analysis of the attitudes and career plans of future physicians. Conducting individual in-depth interviews with system experts.
Results. The most important incentive for future medical staff is the perspective of work in the field of science, the opportunity to help others, and a sense of self-agency or belonging to a group with a special social status. As a result of the multi-stage study carried out proposals for system recommendations were developed aimed
at reducing the phenomenon of medical deserts and incentives to work in depopulated areas.
Conclusions. Coherent and targeted cooperation between government and local self-government authorities, local and professional communities, can encourage young doctors to work in rural and depopulated areas, and thus help reduce the phenomenon of medical deserts. The presented findings should be considered
as preliminary and require further in-depth exploration.
The role of AI, telemedicine and digital tools in alleviating the phenomenon of medical deserts. 2025
Magdalena Łoś1,3, Adrian Kuś1, Marika Guzek1, Paulina Wójcik1, Aleksandra Prusaczyk-Świerzewska1, Piotr Gryza2, Jakub Magdziarz3, Łukasz Lasyk2
1 Medical and Diagnostic Center, Siedlce, Poland; 2 DIGITMED, Poland; 3 Medical University of Warsaw, Poland
Background. Medical deserts, regions with limited access to healthcare services, pose a significant challenge to global health equity. They result from factors such as geographic isolation, economic constraints, healthcare workforce shortages, and technological barriers. The rise of artificial intelligence (AI), telemedicine, and large
language models (LLMs) offers promising solutions to mitigate these disparities by expanding healthcare accessibility and improving efficiency.
Aim of the study. This review explores the role of AI, telemedicine, and digital tools in alleviating the phenomenon of medical deserts. It evaluates their applications, benefits, challenges, and real-world implementations, with a special focus on Poland’s healthcare system.
Methodology. A comprehensive literature review was conducted on AI-driven healthcare applications, telemedicine solutions, and LLMs in medical settings. Sources include peer-reviewed studies, governmental reports, and case studies from healthcare systems worldwide.
Results. AI and telemedicine have demonstrated significant potential in increasing healthcare accessibility in rural and remote areas. Telemedicine enables remote consultations, remote patient monitoring (RPM), and teleradiology, reducing travel time and costs for patients in underserved regions. AI-driven tools, such as predictive analytics, automated diagnostics, and intelligent triage systems, help optimise healthcare resources and alleviate workforce shortages. LLMs, including GPT-4, enhance clinical decision-making, automate medical documentation, and provide AI-driven patient education. However, challenges such as digital infrastructure gaps, regulatory limitations, and AI model transparency must be addressed to ensure equitable and ethical implementation.
Conclusions. AI, telemedicine, and LLMs are transformative technologies that can significantly reduce the impact of medical deserts. While they improve healthcare accessibility and efficiency, their integration requires robust infrastructure, regulatory adaptation, and ethical considerations. Further research and policy efforts should focus on expanding digital health initiatives, particularly in low-resource settings, to ensure sustainable and inclusive healthcare solutions.
Prognosis of the real and required demand for family medicine services in Poland. 2025
Małgorzata Kalisz1, Anna Kordowska1, Jolanta Michałowska1, Leszek Średziński1, Anna Krawczyk2, Magdalena Łoś12
1 Medical and Diagnostic Center in Siedlce, Poland; 2 Medical University of Warsaw, Poland
Background. Family medicine forms the foundation of the healthcare system, ensuring comprehensive and continuous care for the population. Understanding the gap between actual and required demand for primary healthcare (PHC) services is crucial for optimising resource allocation and improving patient outcomes.
Aim of the study. This study concept aims to assess the real versus required demand for primary healthcare services in Poland. The research results can be used as an assessment of future staffing strategy in primary care.
Methodology. The real demand was estimated based on historical utilization data of PHC services across different age groups over the past 3 years, assuming similar future trends. The required demand will be additionally determined by analyzing the recommended number and type of services that should be provided annually for each age group, along with the estimated duration of these services, based on experiences of Medical and Diagnostic Center in Siedlce, Poland.
Results. Values projected with the model of the real demand, demonstrate a persistent future shortage of family medicine specialists in Poland. In 2020 there was a shortage of 6,029 family doctors, which resulted in only 64.40% of needs being met. Over the next 25 years, this percentage will only increase to 78.25%, lacking 3352 specialists. The study revealed that the required demand for PHC services exceeds the real demand, indicating a potential gap in healthcare utilization. Enhancing health awareness and preventive care could lead to increased service utilization. However, without adjustments in healthcare workforce capacity, a rise in demand may compromise service availability and accessibility.
Conclusions. Bridging the gap between real and required demand requires strategic workforce planning and
health education initiatives. Policymakers should consider optimising PHC capacity to meet the population’s
actual healthcare needs effectively.
Coordinated care in PHC in Poland: Patients’ perspective, 2024
Sabina Karczmarz1, Artur Prusaczyk1, Magdalena Kołodziej2, Agnieszka Mastalerz-Migas3, Marcin Połowniak4
1 Medical and Diagnostic Centre (MDC), 08-110 Siedlce, Poland; 2 WE Patients Foundation; 3 Polish Society of Family Medicine; 4 Value Based Integrated Care Employers Association
Background. In October 2022, the implementation of coordinated care (CC) started in Poland. It was a response to low-quality capitation-based model of PHC funding and concept to overcome deficiencies in care management for people with chronic diseases. CC is a concept aimed at improving quality of medical services and efficiency of use of resources in ambulatory health care.
Aim of the case report. Coordinated care was introduced as a model of care covering patients with chronic diseases in cardiology, diabetology, endocrinology, pulmonology and, a year later, nephrology. 38% of PHC providers implement coordinated care, covering 48% of Poland’s population. After 2 years, we conducted a survey of 1024 patients under CC. The project leader was an NGO and partners – scientific societies and employers’ associations.
Case report. The overall perception of CC is very positive. Key conclusions point to improved access to SHC, better organization of appointments and more effective communication between patients and medical staff. Respondents point to faster access to consultations and more efficient use of diagnostic tests. Integration of services and support of coordinator at clinics are highly rated. Patients feel safer and better informed about their health, which significantly improves their treatment experience. More than 92% of patients are satisfied with their level of involvement in decisions regarding diagnosis and treatment, a positive indicator of effective cooperation between patients and care professionals.
Conclusions. Most patients recommend CC to their relatives, pointing to its effectiveness and convenience. Patients appreciate the possibility of faster access to specialists and better organization of the treatment process. Among the recommendations for improving care, patients point to the need to increase the availability of CC in smaller localities and to introduce additional services, such as psychological and neurological care, as well as rehabilitation. The key aspect is to maintain the pace of development, quality control, evaluation and improvement of the system.
Future of Polish primary care: Projection of demand and number of family doctors till 2045, 2024
Magdalena Bogdan1, Małgorzata Kalisz2, Mariusz Zamyłko2, Anna Kordowska2, Anna Krawczyk3
1 Medical University of Warsaw, Poland; 2 Medical and Diagnostic Centre in Siedlce, Poland; 3 Medical University of Warsaw, Poland
Background. Family doctors are a key link in the healthcare system, especially in primary care. In 2020, the number of family doctors in Poland only reached 64.4% of the required number needed as defined by the National Consultant for Family Medicine. The average age of family doctors is 55.23 years, while for all physicians (excluding physicians with no specialization) the average age is 54.97 years. People of retirement age (65+) accounted for 19.82% of all professionally active family doctors.
Objectives. The aim of the study was to project the demand and the number of family doctors in Poland until 2045. This study can be used as an assessment of current staffing strategy in primary care.
Methodology. The analysis was based on the data from the Database of Systemic and Implementation Analyses of the Polish Ministry of Health. The projection model was developed using Microsoft Excel, including specially prepared life tables as the basis of the model. The following groups of supply factors were taken into account: age structure, inflow of family doctors to the labor market, outflow of family doctors from the profession, and as a demand factor – the demand for family doctors.
Results. Values projected with the model demonstrate a persistent future shortage of family medicine specialists in Poland. In 2020 there was a shortage of 6,029 family doctors, which resulted in only 64.40% of needs being met. Over the next 25 years, this percentage will increase to 78.25%, lacking 3,352 specialists.
Conclusions. The results of the study show that the current strategy for improving the health care system in the case of primary care and family medicine is not effective in the long term. Worrisome prediction yields call for an alternative systemic approach; one targeted more towards primary care physicians and implementation of telemedicine and new technologies.
Attitudes of future physicians in the context of searching methods for reducing medical deserts, 2024
Magdalena Bogdan1, Artur Prusaczyk2, Paweł Żuk2, Łukasz Śmiejkowski2, Anna Świrska2, Kamil Cołoś3
1 Medical University of Warsaw, Poland; 2 Medical and Diagnostic Centre in Siedlce, Poland; 3 Medical University of Warsaw, Poland
Background. Shortages of primary care, specialised, and emergency care contribute to the emergence of medical deserts, which are regions where the population lacks sufficient access to healthcare. Access to high-quality care, essential medicines and assistive technologies should be available to all patients,
regardless of where they live.
Objectives. The main aim of the study is to identify factors influencing the career decisions of medical students. These factors have a significant impact on the subsequent allocation of the medical workforce in Poland.
Methodology. For the purposes of the study, a conceptual research model was followed, which included analysis and inference procedures. The model consists of 5 sections grouped into 3 research stages: Preparation, diagnosis and verification. The study included 1st, 3rd and 6th year medical students at the Medical University of Warsaw. The preparation stage comprised the analysis of professional literature and existing data. The diagnosis stage consisted of carrying out planned quantitative and qualitative research. During the verification stage, the results obtained from the quantitative and qualitative research will be evaluated by a group of experts.
Results. The study classifies factors influencing career choice among medical students and the factors influencing this choice. The various factors identified by the students of specified years will be sorted and analysed This will provide information on the problems of the medical deserts in Poland.
Conclusions. It is assumed that the research findings will assist in optimizing the medical education system as well as managing human resources more effectively in the health care sector. The research results should thereby improve the quality and availability of health care in Poland, including reducing medical deserts.
Pharmaceutical care introduced in coordination with PHC in Poland: Perspectives of physicians, pharmacists and patients. 2024
Joanna Oberska1, Joanna Siennicka2, Jolanta Pańkowska2, Błażej Jurewicz2, Damian Chaciak2
1 Warsaw Medical University, Poland; 2 Medical and Diagnostic Centre Siedlce, Poland
Background. Care coordination improves health care outcomes and facilitates the utilization of efficient, safe, and high-quality services while maximizing the accessibility of services offered to patients. In collaboration with other healthcare professionals, pharmacists can ensure that patients receive the most effective and safe treatment possible. In many countries such as the United States, the Netherlands, and United Kingdom, pharmacists are actively involved in providing care in primary care and ensuring continuity of care for patients. Coordinated PHC care in Poland has been introduced to include GPs, specialists, nurses, and dietitians, but without the involvement of pharmacists. Pharmacists in Poland have received rights to provide additional services to patients already in 2021, but new services have not yet been implemented.
Objectives. The study aims to explore the perspectives of physicians, pharmacists, and patients on pharmaceutical care, physician-pharmacist collaboration, and advanced pharmacy services that could be introduced in coordination with PHC in Poland.
Methodology. A method used in the project will be an online survey (CAWI) which will be distributed by email to all invited to the survey. Three separate questionnaires will be developed for physicians, pharmacists, and patients. The survey will consist mainly of closed questions. Survey items will be adjusted to each group, but they will cover the same themes: current approach to pharmacotherapy management, collaboration between physician and pharmacist, and need for additional services delivered by pharmacists. A random sample of 1000 respondents will be selected from each group in order to ensure a measurement error of 5%.
Results. Statistical analysis will be performed on the obtained results. Comparative analysis will be used to compare results between groups.
Conclusions. The obtained results may provide perspectives of different groups on pharmacists’ role in pharmacotherapy management and what additional tasks they can take on. Conclusions from the study can be used in designing policies including pharmacists in coordinated care in Poland.
The attitudes of patients, under coordination in primary care, in rural areas on vaccinations against COVID-19: Research results and further recommendations. 2024
Sabina Karczmarz1, Paweł Żuk2, Marika Guzek2, Marta Miros2, Joanna Oberska3
1 IFIC Poland; 2 Medical and Diagnostic Centre, Siedlce, Poland; 3 Warsaw Medical University, Poland
Background. Vaccinations are recognised in the history of medicine as the most effective method of prevention in combating infectious diseases. They allow for the control of the course and extent of these diseases, and also significantly contribute to the complete elimination of these diseases. However, the implementation of a global vaccination programme requires a high level of social approval, and thus factors that influence patients’ attitudes toward vaccinations.
Objectives. The main aim of the study was to determine the factors determining the willingness or refusal to be vaccinated against COVID-19.
Methodology. The test was performed using the CAPI technique at the Medical and Diagnostic Centre in Siedlce. Interviews using the LSQ-Cavendish diagnostic questionnaire were conducted among healthy and chronically ill patients. The study took into account the influence of socio-demographic characteristics and lifestyles of patients coordinated in primary care in rural areas and small towns. Categories of vaccinated and unvaccinated subjects were compared using chi-square and Mann–Whitney U tests.
Results. The results show that there are significant differences between vaccinated and unvaccinated groups in terms of gender, age, and professional status. Women, people aged 65 and older, actively working and working physically were more often vaccinated against COVID-19. There was no significant impact of place of residence, education, relationship status, and household size on patients’ attitudes. The study showed that the categories of vaccinated and unvaccinated patients differ in their health lifestyles. Interestingly, unvaccinated people had a higher rate of healthy lifestyle, while vaccinated people were more likely to follow an unhealthy lifestyle.
Conclusions. The conclusions of the study indicate the need for further research on the effectiveness of information campaigns and flexible communication strategies that take into account social diversity and patient concerns. These actions can help increase public acceptance of vaccination programmes and ensure public health protection.
“Scirocco” tool usage: Medical and Diagnostic Centre case-study. 2024
Anna Owczarczyk1, Magdalena Bogdan2, Paweł Żuk3
1 Military University of Technology, Siedlce, Poland; 2 Warsaw Medical University, Poland; 3 Medical and Diagnostic Centre, Siedlce, Poland
Background. The Scirocco tool was developed by the B3 Action Group on Integrated Care of the European Partnership for Innovation, Active and Healthy Ageing to determine the level of readiness for integrated care based on the concept of regionalization of PHC. Scirocco allows all health care entities, including PHC, to give a holistic view of their own activities, showing the strengths and weaknesses in the regional context for integrated care, and allows for the exchange of experiences and good practices between institutions. It is available in an on-line questionnaire format for all interested stakeholders. An analysis of the areas included in the Scirocco model allows for the conclusion that they are so universal that it is possible to use this questionnaire not only to assess readiness for the implementation of integrated care, but also coordinated healthcare.
Objectives. Presentation of the maturity model for the implementation of integrated care “Scirocco” and an attempt to evaluate its application in the Medical and Diagnostic Centre in Siedlce area for coordinated care. Case report. The study at the Siedlce Medical and Diagnostic Centre was carried out in 2017, at the time when the pilot national coordinated care programme “POZ+” was implemented. In 2017 an initial assessment of maturity of the CMD and the Polish healthcare system for the coordinated care was made. In 2024 – re-examination the maturity of CMD. The Authors examined the degree of changes that have taken place in healthcare both in CMD as in the Polish healthcare system.
Conclusions. A comparative analysis of the CMD’s responses allows us to conclude that there has been a significant change in the assessment of areas that determine readiness for coordinated care. It was possible mostly due to regulations that have been introduced in Polish legal system, changes in the funding system,
and the development of digitization.
Implementation of coordinated care in PHC in Poland: Preliminary results. 2024
Anna Owczarczyk1, Magdalena Bogdan2, Paweł Zuk3, Maciej Karaszewski4
1 Military University of Technology, Siedlce, Poland; 2 Warsaw Medical University, Poland; 3 Medical and Diagnostic Centre, Siedlce, Poland; 4 National Health Fund, Poland
Background. Coordinated healthcare is a concept that aims to improve the quality of healthcare delivery and the efficiency of resource use in healthcare. The Polish legislator has defined it as an integrated system of providing health care services, covering all stages and elements of the process of their implementation,
with the use of ICT systems, electronic communication tools or available public telecommunications services. Coordinated care services address the diagnosis and treatment of selected chronic diseases, such as hypertension, heart failure, diabetes, bronchial asthma and chronic obstructive pulmonary disease, hypothyroidism and chronic kidney disease and can be carried out in PHC entities.
Objectives. The aim is to present the process of implementation of coordinated care in Polish healthcare system as well as the preliminary results of its implementation.
Case report. Coordinated care (CC) was introduced with the PHC+ pilot programme in 2017, with the pilot covering more than 350,000 patients. The idea of coordinated care worked well, and in 2022 financial support from the National Health Fund and legislation were introduced to formally anchor coordinated care services in clinics. The proposed changes within CC, according to the Health Ministry, are aimed at increasing the availability of services at the PHC level to expand initial diagnosis at this stage. This will speed up the determination and implementation of appropriate therapy. In addition, the changes are expected to have the effect of relieving the burden on hospital emergency departments.
Conclusions. The number of providers providing coordinated care in 2023 were 418. This represents 23% of total providers in Poland. The largest number of contracts for the provision of services, financed under coordinated care budget were 957, assigned to clinics with up to 5,000 patients. In 2024, the number of CC services amounted to 2,168,361, with a value of more than PLN 220 million ($547).
Coordinator of integrated primary care – competences of a new healthcare worker
Family Medicine & Primary Care Review, 2024
Celem było określenie oczekiwanych kompetencji koordynatora w świetle potrzeb pracodawców i możliwości systemu edukacji.
Analiza zidentyfikowała szereg nowych, unikalnych kwalifikacji. W obszarze wiedzy: rozumienie pracy w POZ, w tym nowych koncepcji (opieka skoncentrowana na pacjencie, opieka oparta na wartości, deinstytucjonalizacja), podejście populacyjne, kluczowe mierniki opieki zdrowotnej, komunikacja interpersonalna i zdrowotna, podstawy pracy klinicznej wszystkich członków zespołu interdyscyplinarnego, raportowanie świadczeń.
W obszarze umiejętności: komunikacja z wykorzystaniem systemów call-center, organizacja pracy zespołowej, identyfikacja pacjentów do interwencji zdrowotnych w systemach informatycznych, skuteczna rekrutacja, ewaluacja działań POZ, coaching zdrowotny i rzecznictwo, prowadzenie kampanii zdrowotnych w mediach społecznościowych. W odniesieniu do kompetencji społecznych: koordynator powinien budować i utrzymywać stałe i utrzymywać stałe relacje między członkami zespołów interdyscyplinarnych, być otwarty na zmiany i nowe rozwiązania, może być przewodnikiem dla pacjenta i ma postawę nastawienie na pacjenta.
Bartosz Pędziński, Anna Owczarczyk, Katarzyna Badora-Musiał, Magdalena Bogdan, Małgorzata Gałązka-Sobotka, Iwona Kowalska-Bobko
Link do publikacji: https://www.termedia.pl/Coordinator-of-integrated-primary-care-competences-of-a-new-healthcare-worker,95,53987,0,1.html
Organisational aspects of anti-HPV vaccination compared to anti-SarsCoV2 vaccination in Poland affecting effectiveness, 2023
Sylwia Szafraniec-Burylo1, Artur Prusaczyk2, Katarzyna Rubnikowicz2
1 Institute of Mother and Child Warsaw Poland Department of Pharmacoeconomics, Warsaw, Poland; 2 Medical and Diagnostic Centre in Siedlce, Poland
Background: Anti-SarsCoV2 vaccination programme in Poland is easily accessible, offered for free for people at least 5 years of age and publicly funded by the government. Anti- HPV (Human Papillomavirus) vaccination is primarily targeted at adolescents before they become sexually active. In Poland, publicly funded HPV vaccination programme is offered for free to adolescents in the age of 12-13 years, aiming to protect them against HPV infections that can lead to cervical cancer and other related diseases.
Aim of the study: Outlining the aspects that can be improved in the anti-HPV vaccination program based on the experience of the anti-Sars Cov2 vaccination program.
Methodology: Interviews with representatives of the primary health physicians organisation.
Results: Anti-SarsCoV2 vaccination programme in contrast to anti-HPV vaccination programme uses a mature IT system, e-registration integrated with primary health physicians office programs, various organizational forms of reaching patients, staff training on clinical and organizational merits, a „population meter” of vaccination coverage of age groups.
It is necessary to prepare an implementation and executive plan allowing for population-relevant coverage. We propose a plan containing the following stages of building effectiveness: opportunistic activity for volunteers, cooperation with the education sector, inclusion of the „healthy school” campaign, using each contact to vaccinate young people. It is worth considering extending the period of vaccination possibility for given age groups after the age of 14, and for the willing opportunistic group after the age of 9 according to the SmPC. Necessarily central and local support in the fight against disinformation about public health with the involvement of the greatest authorities of our international health care system. Necessary cooperation with all primary care physicians (cooperation of the medical self-government in reaching these physicians).
Conclusions: Proper education and awareness campaigns can address misconceptions and encourage parents and caregivers to consent to the vaccination for their children.
The role of coordinated care in shaping health-conscious lifestyle and attitude among patients, 2023
Sabina Karczmarz1, Anna Kordowska1, Anna Owczarczyk2, Paweł Żuk1, Artur Prusaczyk1, Magdalena Bogdan3
1Medical and Diagnostic Center in Siedlce, Poland; 2Department of Logistics, Security and Management, Military University of Technology; 3Department of Social Medicine and Public Health, Medical University of Warsaw, Poland
Background. Lifestyle reflects how individuals and societies act in the physical, psychological, social and economic environment on a daily basis. According to the World Health Organization (WHO), lifestyle and health behaviors influence the quality of life as they are significant moderators of physical and mental health and can affect health up to 60% (4). A comprehensive lifestyle assessment is essential to identify unhealthy behaviors and prevent their consequences for health.
Aim of the Study. The aim of the study was to analyze and assess the role of coordinated care in shaping health-conscious lifestyle and attitude among patients, as well as to analyze the possibility of shaping patient’s attitude by medical staff through new solutions.
Methodology. The research methodology was based on the review of available source literature. Scientific articles on the research topic were selected using the following keywords in two electronic databases (PubMed and Scopus): coordinated care, lifestyle, healthy attitude, health promotion and primary care. The last search was made on 25/01/2023. Articles in languages other than Polish and English were excluded.
Results. A health care model based on coordinated care should be focused on the patient, use preventive activities and respond to contemporary challenges in the health sector. An analysis of scientific and social sources as well as and legal regulations leads to a conclusion that primary health care in Poland can meet the needs of citizens in terms of accessibility management: it can solve basic emergency problems and manage diseases; stabilize patients with chronic diseases within PHC in cooperation with specialist outpatient care; and manage care, in particular implement preventive screenings, health education and early diagnosis of diseases.
Conclusions. In conclusion, the role of coordinated health care in shaping health-conscious lifestyle and attitude among patients is very important. In the long run, coordinated health care should bring about effects in the organization of care, including better integration, accessibility and efficiency of services, as well as, perhaps most importantly of all, a change in patients’ attitude to health and improvement in the lifestyle of the whole society.
Effectiveness of medicine reviews introduced in coordination with Primary Health Care, 2023
Joanna Oberska1, Paweł Żuk2, Artur Prusaczyk2, Magdalena Bogdan1
1Department of Social Medicine and Public Health, Medical University of Warsaw, Poland; 2Medical and Diagnostic Center in Siedlce, Poland
Background. Pharmacist services have the potential to lower medical costs and improve patients’ clinical outcomes. They are also better accessible to Polish patients in comparison to other healthcare professionals. They can therefore support patients in rural areas in accessing quality care. Pharmacists in Poland have received rights to provide additional services to patients in 2021, but new services have not yet been implemented. National Pilot Program for medicine review service focused on identifying drug problems in patients identified in pharmacies with no access to patients medical history.
Aim of the Study. Objective of the planned research project is to analyse effectiveness medicine reviews for hearth failure patients performed by pharmacists as part of coordinated care with primary health care providers. Effectiveness is understood by change in prescribing rates of GDMT medication which positively impacts patients clinical outcomes as well as changes in patient outcomes (disease control, health-related quality of life, adherence).
Methodology. Randomized Clinical Trial will be conducted. Study would look to include at least 200 patients with heart failure, using 5 or more medications daily who have been enrolled in coordinated care. Patients will be randomised into 1:1 intervention arm (receiving medicine review) and control arm (receiving standard of care).
Results. Study will analyse the results in connection with primary endpoint: prescribing rates of GDMT medications and secondary endpoints: quality of life (as measured by Minnesota Living with Heart Failure Questionnaire (MLHFQ), adherence (as measured by Morisky Adherence Scale), all-cause hospitalization, all-cause mortality. As part of exploratory endpoints, changes in proBNP will be measured.
Conclusions. The research is looking to bridge the science gap in effectiveness assessment of medicine reviews delivered by pharmacists and improve access to healthcare for patients in rural areas by including pharmacists in PHC team.
Participation of future medical personnel in primary care in building public trust in vaccinations, 2023
Magdalena Bogdan1, Sabina Karczmarz2, Anna Kordowska2, Anna Owczarczyk3, Paweł Żuk2, Kamil Cołoś1
1 Department of Social Medicine and Public Health, Medical University of Warsaw, Poland; 2Medical and Diagnostic Center in Siedlce, Poland; 3Department of Logistics, Security and Management, Military University of Technology
Background. Prevention through vaccinations in the group of healthcare professionals provides protection not only to this particular group, but also to their environment, including their patients. The research results show, that vaccine promotion is most important in primary care. Students of the senior years of medical faculties are persons who will become healthcare professionals in the near future and will be soon responsible for taking care for a patients.
Aim of the Study. The aim of the study was to analyze the attitudes of future medical personnel towards flu and COVID-19 vaccinations, analyze factors that influence the attitudes, and to assess their knowledge and awareness of safety, effectiveness and necessity of vaccinations.
Methodology. The research tool was a self-made questionnaire. The study was conducted in the group of students of the Medical University of Warsaw, majoring in medicine, nursing, midwifery (and emergency medicine.
Results. It has been shown that the vast majority of those surveyed were convinced of the importance and effectiveness of preventive vaccinations. The study also proves that proper education about vaccinations can increase the number of healthcare professionals who decide to undergo mandatory and recommended vaccinations. Persons who have the knowledge about vaccinations and their health and social benefits are more likely to decide to get vaccinated. The study also showed that the knowledge gained during medical studies is the basis for building awareness of future medical staff in the field of preventive vaccinations.
Conclusions. Younger future doctors are more confident in vaccines and recommend them for patients more frequently. It is essential to improve institutional and educational communication addressed to young doctors to enhance their role as vaccination (both flue and COVID-19) facilitators. The results obtained in this study may be used to make a suggestion for medical universities and medical self-governing bodies.
Rola koordynowanej opieki zdrowotnej w kształtowaniu stylu życia i postaw prozdrowotnych pacjentów
Terapia, 2023
Styl życia rozumiany jest jako sposób życia, który odzwierciedla codzienne radzenie sobie jednostek, społeczeństw ze środowiskiem fizycznym, psychologicznym, społecznym i ekonomicznym. Pojęcie stylu życia ma swoje korzenie w antropologii, socjologii i klinicznej psychologii, gdzie opisuje się go jako trwałe i powtarzalne wzory, które są kombinacją dziedziczenia kulturowego, społecznych interakcji, geograficznego i społeczno-ekonomicznego położenia oraz osobowości. Styl życia determinuje zdrowie ludzkie poprzez całokształt powiązanych ze sobą zachowań, zwyczajów i nawyków, które mogą mieć wpływ na poziom ryzyka przedwczesnego rozwoju określonych chorób.
Przybywa dowodów na to, jak czynniki związane ze stylem życia oddziałują na nasze zdrowie. Według World Health Organization (WHO) styl życia i zachowania zdrowotne przekładają się na jakość życia, stając się istotnymi moderatorami zdrowia fizycznego i psychicznego – mogą wpływać na zdrowie nawet w 60%.
mgr n. ekonom. Sabina Karczmarz dr n. ekonom. Magdalena Bogdan dr n. ekonom. Anna Owczarczyk lek. Paweł Żuk lek. Artur Prusaczyk prof. dr hab. n. med. i n. o zdr. Aneta Nitsch-Osuch mgr n. o zdr. Kamil Cołoś mgr farm. Joanna Oberska
Link do publikacji: https://terapia.com.pl/pl/node/5555
Efficiency and Effectiveness of Patient Care Provided by Physicians in Rural and Urban Areas in Poland
National Library of Medicine, 2023
Lekarze pracujący na obszarach wiejskich leczyli więcej pacjentów z powodu niedoborów personelu. Lekarze pracujący na obszarach miejskich wykazali się większą skutecznością w przeprowadzaniu rutynowych i zaawansowanych badań oraz mammografii. Pomimo tej przewagi, średnia długość życia pacjentów była wyższa wśród pacjentów lekarzy pracujących na obszarach wiejskich. Badanie podkreśla różnice w wydajności i skuteczności lekarzy pracujących na obszarach wiejskich i miejskich oraz podkreśla potrzebę uwzględnienia tych różnic przez decydentów w zakresie opieki zdrowotnej w odniesieniu do alokacji zasobów opieki zdrowotnej.
Artur Prusaczyk, Mariusz Gujski, Wojciech Onyśków, Paweł Żuk, Leszek Warsz, Aneta Nitsch-Osuch, Joanna Oberska, Magdalena Bogdan
Link do publikacji: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10424557/
Efektywność wdrożenia opieki farmaceutycznej
Terapia, 2023
Doświadczenia krajów na całym świecie oraz metaanalizy badań klinicznych dowodzą, że włączenie farmaceutów w opiekę zdrowotną i umożliwienie im świadczenia dodatkowych usług zdrowotnych pozytywnie wpływa na zdrowie pacjentów. Jest to szczególnie korzystne w przypadku następujących usług:zarządzanie chorobami przewlekłymi, przeprowadzanie badań przesiewowych, podawanie szczepień ochronnych, wspieranie pacjentów w rzucaniu palenia, wykonywanie przeglądów lekowych czy kierowanie pacjentów do specjalistów i umożliwienie zachowania ciągłości leczenia. Wypracowując nowe ścieżki zarządzania w ochronie zdrowia w Polsce, należałoby uwzględnić potencjał farmaceutów, jako że są szeroko dostępni i cieszą się zaufaniem społecznym.
mgr farm. Joanna Oberska, lek. Paweł Żuk, Błażej Jurewicz, prof. dr hab. n. med. i n. o zdr. Aneta Nitsch-Osuch, dr n. ekonom. Magdalena Bogdan
Link do publikacji: https://terapia.com.pl/pl/node/5563
Integrating Care to Prevent and Manage Chronic Diseases Best Practices in Public Health, 2023
Autorski model opieki nad pacjentami z chorobą przewlekłą w POZ,oparty o prawie 20-letnim doświadczeniu Centrum Medyczno-Diagnostyczne go, znalazł się w gronie najlepszych praktyk OECD.Model został oceniony w pięciu kryteriach m.in. poprawy efektywności i możliwości przeniesienia do innych krajów OECD i UE-27.
Raport przedstawia zalecenia dotyczące polityki zapobiegania chorobom przewlekłym i zarządzania nimi poprzez integrację opieki.Zalecenia polityczne zostały opracowane na podstawie przeglądu kluczowych modeli zintegrowanej opieki wdrożonych w krajach OECD i UE-27.
Link do publikacji:
https://www.oecd-ilibrary.org/social-issues-migration-health/integrating-care-to-prevent-and-manage-chronic-diseases_9acc1b1d-en
Koordynowana opieka zdrowotna w praktyce. Od POZ – do POZ+
redakcja naukowa Magdalena Bogdan, Anna Owczarczyk, Paweł Żuk, Artur Prusaczyk, Sabina Karczmarz
Publikacja prezentuje najważniejsze metody, narzędzia oraz wskazówki przygotowania, wdrożenia i oceny koordynowanej opieki zdrowotnej w POZ.
Opisuje autorski model opieki koordynowanej oraz krok po kroku prowadzi przez etapy zarządzania zdrowiem populacyjnym.
Health Care Organization in Poland in Light of the Refugee Crisis Related to the Military Conflict in Ukraine
International Journal of Environmental Research and Public Health 2023
Strategia wdrażania zmian w polskim systemie ochrony zdrowia opiera się na budowaniu odporności ochrony
zdrowia i adaptacji do różnych kryzysów.
A. Prusaczyk, M. Bogdan, S. Vinker, M. Gujski, P. Żuk, I. Kowalska-Bobko, S. Karczmarz, J. Oberska, K. Lewtak
Link do publikacji: https://www.mdpi.com/1660-4601/20/5/3831
Rola koordynowanej opieki zdrowotnej w kształtowaniu stylu życia i postaw prozdrowotnych pacjentów
Medycyna Rodzinna 2023
Celem niniejszej pracy jest analiza i ocena roli koordynowanej opieki zdrowotnej w kształtowaniu stylu życia i postaw prozdrowotnych pacjentów, w szczególności w POZ, jak również analiza możliwości kształtowania postaw przez personel dzięki nowym rozwiązaniom, jakie przynosi systemowe wdrożenie opieki koordynowanej.
Czynniki determinujące zdrowie człowieka obejmują styl życia, zachowania zdrowotne, środowisko fizyczne, kulturowe i psychospołeczne, czynniki genetyczne i opiekę zdrowotną. Zdrowy styl życia jest związany z określoną dietą, unikaniem tytoniu i alkoholu, aktywnością fizyczną i umiejętnością radzenia sobie ze stresem. Analizy
pokazują, że osoby prowadzące najzdrowszy styl życia mają niższe ryzyko śmierci, zdarzeń sercowo-naczyniowych i chorób układu krążenia, i cukrzycy. Przeprowadzenie kompleksowej oceny stylu życia jest niezbędne do identyfikacji niezdrowych zachowań i zapobiegania ich konsekwencjom.
Polacy chcieliby żyć zdrowiej, ale mają problemy z wdrożeniem i utrzymaniem nawyków. 85% deklaruje troskę o swoje zdrowie, a tylko 14% nie angażuje się w działania
w działania mające na celu poprawę stanu zdrowia. Statystyki dotyczące zachowań i stanu zdrowia są nieco sprzeczne. Ponad połowa Polaków cierpi na problemy z nadwagą, jedna czwarta dorosłych Polaków pali papierosy, a jedna trzecia nie uprawia regularnie aktywności fizycznej.
Skoordynowana opieka zdrowotna może mieć pozytywny wpływ na zdrowie społeczeństwa. Prowadzi do poprawy wskaźników wskaźników efektywności systemu, które obejmują dostępność, jakość i skuteczność opieki. Prowadzi działania edukacyjne, profilaktyczne i promocyjne, które wpływają na styl życia i postawy prozdrowotne pacjentów objętych opieką. Podstawowa opieka zdrowotna w Polsce może zaspokajać potrzeby obywateli w zakresie zarządzania dostępnością – zabezpieczenie podstawowych
problemów nagłych, zarządzania chorobą – stabilizacji pacjentów z chorobą przewlekłą realizowane przez zespół POZ oraz współpracę ze specjalistami AOS, w tym w szczególności zarządzanie zdrowiem – prowadzenie badań profilaktycznych, edukacji zdrowotnej i wczesnej diagnostyki chorób
mgr n. ekonom. Sabina Karczmarz, dr n. ekonom. Magdalena Bogdan, dr n. ekonom. Anna Owczarczyk, lek. Paweł Żuk, lek. Artur Prusaczyk, prof. dr hab. n. med. i n. o zdr. Aneta Nitsch-Osuch, mgr n. o zdr. Kamil Cołoś, mgr farm. Joanna Oberska
Efektywność wdrożenia opieki farmaceutycznej
Medycyna Rodzinna 2023
Zwiększona oczekiwana długość życia i starzejące się społeczeństwo powodują, że podstawowa opieka zdrowotna w Polsce, podobnie jak w innych krajach na świecie,
obejmuje coraz większą liczbę pacjentów z wielochorobowością i złożoną farmakoterapią. Obecne obciążenie pracą i niedobór kadr medycznych pokazują, że potrzebne są nowe
sposoby organizacji opieki zdrowotnej, aby wspierać zawody medyczne i pacjentów i zapewnić wysoką jakość opieki.
Opiekę farmaceutyczną (OF) definiuje się jako odpowiedzialność za zapewnienie skutecznej farmakoterapii, która poprawia jakość życia pacjentów. Poprawa sposobu stosowania leków jest jednym z głównych celów tej opieki, a do osiągnięcia maksymalnych korzyści oraz uniknięcia działań niepożądanych leczenia potrzeba pełnej współpracy i zaufania między pacjentem a farmaceutą. W ustawie o zawodzie farmaceuty opieka farmaceutyczna definiowana jest „jako świadczenie zdrowotne stanowiące dokumentowany proces, w którym farmaceuta współpracuje z lekarzem i pacjentem i czuwa nad przebiegiem farmakoterapii”.
mgr farm. Joanna Oberska, lek. Paweł Żuk, lek. Błażej Jurewicz, prof. dr hab. n. med. i n. o zdr. Aneta Nitsch-Osuch, dr n. ekonom. Magdalena Bogdan
Efficiency and Effectiveness of Patient Care Provided by Physicians in Rural and Urban Areas in Poland
Medical Science Monitor 2023
Sektor ochrony zdrowia w Polsce stoi obecnie w obliczu wyzwań, takich jak ograniczone zasoby finansowe, słaba infrastruktura i niewystarczające zasoby ludzkie.Aby rozwiązać te problemy, niezbędne stało się zwiększenie efektywności kosztowej na poziomie indywidualnego lekarza. Niniejsze badanie miało na celu ocenę efektywności i skuteczności opieki nad pacjentem na poziomie poszczególnych lekarzy podstawowej opieki zdrowotnej oraz porównanie wyników lekarzy pracujących na obszarach miejskich i wiejskich.
Trzynaście autorskich wskaźników efektywności opracowano na podstawie przeglądu literatury, konsultacji eksperckich oraz badania pilotażowego w Centrum Medyczno-Diagnostycznym w Siedlcach. Wskaźniki zostały wykorzystane do oceny efektywności lekarzy oraz porównania charakterystyki lekarzy pracujących na obszarach wiejskich i miejskich.W badaniu zebrano dane dotyczące charakterystyki lekarzy i wykorzystano wskaźniki do oceny ich skuteczności.
Lekarze pracujący na obszarach wiejskich leczyli więcej pacjentów z powodu niedoborów personelu. Jednak lekarze pracujący na obszarach miejskich wykazali się większą skutecznością w przeprowadzaniu rutynowych i zaawansowanych badań lekarskich oraz mammografii. Pomimo tej przewagi, średnia długość życia pacjentów była wyższa wśród pacjentów lekarzy pracujących na obszarach wiejskich.
Pięć wskaźników opracowanych w badaniu utworzyło skalę, która jest krokiem w kierunku opracowania jednolitego wskaźnika skuteczności. Dalsze badania nad spójnym pomiarem efektywności mogą znacząco wpłynąć na rozwój metodologii badań socjometrycznych. Niniejsze badanie podkreśla różnice w wydajności i skuteczności lekarzy pracujących na obszarach wiejskich i miejskich oraz podkreśla potrzebę uwzględnienia tych różnic przez decydentów w zakresie opieki zdrowotnej w odniesieniu do alokacji zasobów opieki zdrowotnej.
Artur Prusaczyk, Mariusz Gujski, Wojciech Onyśków, Paweł Żuk, Leszek Warsz, Aneta Nitsch-Osuch, Joanna Oberska, Magdalena Bogdan
Link do publikacji: https://medscimonit.com/abstract/full/idArt/939169
Behawioryzm oraz koncepcje wpływania na postawy pacjentów wobec zachowań zdrowotnych
Journal of Education, Health and Sport 2023
Pracownicy służby zdrowia w zespołach podstawowej opieki zdrowotnej muszą wiedzieć, jak skutecznie zachęcać pacjentów do zmiany zachowań zdrowotnych, aby osiągnąć cele terapeutyczne. Zrozumienie wzorców behawioralnych i psychologicznego podłoża wprowadzania zmian może pomóc pracownikom ochrony zdrowia w przeprowadzaniu interwencji z wyższym wskaźnikiem skuteczności.
Celem pracy była ocena znaczenia wzorców zachowań w kształtowaniu postaw i zachowań zdrowotnych pacjentów. Istnieją trzy rodzaje teoretycznych modeli, które wyjaśniają, w jaki sposób dochodzi do rozpoczęcia i zmiany zachowań zdrowotnych: modeli motywacyjnych, postintencjonalnych oraz wieloetapowych. Modele motywacyjne opisują rolę poszczególnych zmiennych poznawczych w procesie tworzenia intencji zmiany zachowania.
Zmiana nawyków w kontekście promocji zdrowia odbywać się poprzez oddziaływanie na percepcję pacjentów. Można to osiągnąć za pomocą modeli TRA (Theory of Reasoned Action), TBP (Theory of Planned Behavior) i HBM (Health Belief Model) poprzez przekonywanie społeczeństwa o podatności na daną chorobę, upowszechnianie wiedzy o skutecznych metodach profilaktyki oraz generowanie perswazji, wsparcia, podziwu czy uznania w społeczeństwie po pozytywnym zachowań, takich jak zaprzestanie palenia lub
regularna aktywność fizyczna. Modele postintencjonalne wskazują czynniki zwiększające szansę na przełożenie motywacji na działanie. Zobowiązują one jednostkę do określonego działania, gdy spełnione są określone okoliczności środowiskowe, pomagając w ten sposób w przełożeniu intencji celu na działanie. Modele wieloetapowe opisują zachowania zdrowotne jako obejmujące kilka oddzielnych etapów.
Teorie te bazują na założeniu, że ludzie na różnych etapach będą zachowywać się w różny sposób, a więc rodzaje interwencji i informacji potrzebnych do zmiany zachowania będą się różnić w zależności od etapu na którym się znajdują. Pomaganie pacjentom w wyznaczeniu realistycznych cele, takie jak przejście do następnego etapu, może ułatwić proces zmiany. Skuteczne interwencje behawioralne muszą opierać się na zmianie podejścia personelu medycznego do procesu interpersonalnego z pacjentem. Takie podejście powinno być skoncentrowane na pacjencie i oparte na współpracy. Personel medyczny powinien ocenić wagę, jaką pacjent przywiązuje do swojego zdrowia i procesu leczenia, a co za tym idzie także chęć i motywację do przestrzegania zaleceń. Samo przekazanie informacji nie zagwarantuje zmiany ich zachowania. Personel medyczny powinien stosować techniki aktywnego słuchania (stosowanie pytań otwartych, wyjaśnień, stwierdzeń refleksyjnych i podsumowujących), powinien zachęcać pacjentów do wyrażania obaw i powinien umieć rozważyć zalety i wady różnych podejść terapeutycznych.
Prusaczyk Artur, Oberska Joanna, Żuk Paweł, Guzek Marika, Bogdan Magdalena.
Social marketing in gynecological cancers prevention after the COVID-19 pandemic
Polish Gynecology 2023
Ocena rozwoju i opis cech marketingu społecznego w Polsce i Stanach Zjednoczonych w zakresie profilaktyki nowotworów ginekologicznych oraz osiągnięcia tych krajów. W Stanach Zjednoczonych dostępnych jest więcej materiałów na temat kampanii społecznych społecznych poświęconych profilaktyce nowotworów ginekologicznych, a także więcej organizacji publicznych zaangażowanych w działania prozdrowotne niż w Polsce. W przeciwieństwie do amerykańskich polskie kampanie społeczne nie obejmowały wszystkich typów nowotworów ginekologicznych. Badanie wykazało, że Facebook jest najczęściej wykorzystywaną platformą mediów społecznościowych przez organizatorów kampanii społecznych.
Narzędzia marketingu społecznego są niedostatecznie wykorzystywane w profilaktyce nowotworów ginekologicznych zarówno w Polsce, jak i w Stanach Zjednoczonych, pozostawiając wiele miejsca na poprawę ich wykorzystania w przyszłości.
Izabela Norek, Artur Prusaczyk, Szymon Piatek, Mariusz Bidzinski, Aneta Nitsch-Osuch, Magdalena Bogdan
Health Care Organization in Poland in Light of the Refugee Crisis Related to the Military Conflict in Ukraine
International Journal of Environmental Research and Public Health 2023
Strategia wdrażania zmian w polskim systemie ochrony zdrowia opiera się na budowaniu odporności ochrony zdrowia i adaptacji do różnych kryzysów. Propozycja strategii wdrażania zmian w polskim systemie opieki zdrowotnej powstała w odpowiedzi na ukraiński kryzys uchodźczy przy wykorzystaniu przeglądu literatury na temat zmian organizacyjnych w funkcjonowaniu systemów ochrony zdrowia podczas kryzysów migracyjnych na świecie w ostatnich latach, burzy mózgów i doświadczeń realizatora świadczeń opieki medycznej.
A. Prusaczyk, M. Bogdan, S. Vinker, M. Gujski, P. Żuk, I. Kowalska-Bobko, S. Karczmarz, J. Oberska, K. Lewtak
Link do publikacji: https://www.mdpi.com/1660-4601/20/5/3831
Telecare for a physiological pregnant woman could help to compensate for health inequalities in rural and excluded areas, 2022
Artur Prusaczyk 1, Ewa Prokurat 1, Maciej Prusaczyk 1, Damian Chaciak 1, Tomasz Włodarczyk 1, Mariusz Chrzanowski 2, Sylwia Szafraniec-Buryło 2
1 Medical and Diagnostic Centre, Siedlce, Poland; 2 Institute of Mother and Child, Warsaw, Poland
Background. Epidemiological studies confirm a very strong association between low socioeconomic status and a higher incidence of risk factors, incidence, morbidity and mortality. The resources to which access is determined by social position have a very significant impact not only on life chances, but also on human health opportunities. People with a low social position face many barriers that make it difficult or even impossible to take proper care of their health, e.g. more often than people with a high social position, they have worse housing conditions, lower income, and finally problems with access to health services. The problem of inequalities in health also includes the availability of gynecological and obstetric care in Poland.
The aim of the study is to present a telemedicine model in obstetrics, which could reduce social inequalities in health by improving the access of women from rural areas and excluded in Poland to health care services in the field of telemedicine and e-health and increasing the level of their education in the field of preparation for childbirth and postpartum , breastfeeding and parenting.
The model consists in proposing by the doctor during the visit the implementation of software installed on the patients’ smartphones, supporting the patient’s electronic medical account and electronic pregnancy card, as well as the communicator, supporting the primary health care midwife in conducting a healthy pregnancy, helping in conducting preventive examinations in a pregnant woman according to the standard of perinatal care and completing appropriate questionnaires, enabling the recording of medical information by a gynecologist and midwife taking care of a pregnant woman, informing women about upcoming medical services during subsequent visits, enabling teleconsultation with a record of their course, explanation of test results, issuing e-referrals for examinations, possible e-prescriptions and further recommendations, conducting antenatal tele-education and care for the mother and child after delivery. A pregnant woman will have the opportunity to participate in a virtual childbirth school and will receive a birth plan on her account. A pregnant woman close to the due date will be informed about the possibility of free mobile CTG rental, the test results will be sent to a mobile telemonitoring center, they will be interpreted by artificial intelligence, any irregularities will be assessed by medical staff and appropriate measures will be implemented.
Conclusions. Telemedicine can help to compensate for health inequalities in rural and excluded areas. A good example is the conduct of a healthy pregnancy, which in Poland is one of the tasks of a primary care midwife.
The relationship of lifestyle, attitude towards medical treatment and COVID-19 vaccinations, 2022
Paweł Żuk 1, Paula Roguska 1, Sabina Karczmarz 1, Artur Prusaczyk 1, Magdalena Bogdan 2
1 Medical and Diagnostic Centre, Poland; 2 Department of Social Medicine and Public Health, Medical University of Warsaw, Poland
Background. Vaccination is considered to be the best tool to stop a pandemic. However, this method requires a high level of public approval to be effective, and numerous studies show concerns about vaccines. The subject of fears and attitudes towards vaccination has therefore become a challenge for public health experts and an interesting area for research.
Objectives. The study aims to determine the profile of patients not vaccinated for COVID-19.
Materials and methods. Two research methods will be used in the study. Firstly, an online survey (CAWI) will be used and distributed by e-mail to all invited to the survey or opened with the respondent during the visit. The survey will consist mainly of closed questions. 380 respondents will be randomly selected to ensure a measurement error of 5%. Secondly, 10 individual in-depth interviews (IDI) will be conducted by phone with respondents (or during their visit to the facility) who consent to them in the survey. The purpose of the interviews will be to explain the phenomena identified as the results of the survey. The study will aim to determine the socio-demographic characteristics, general health, motivation and lifestyle of the respondents.
Results. Cluster analysis will be performed to analyse the results. The analysis will allow for differentiation of the responders in terms of health, lifestyle and motivation (each variable will be analysed individually) by gender, age, place of residence, etc.
Conclusions. The obtained results may indicate how lifestyle and adherence influence attitude towards COVID-19 vaccinations. Conclusions from the study can be used in designing future preventive interventions with a broad reach.
Appliance of social marketing in gynaecologic cancers prevention after pandemic COVID-19, 2022
Magdalena Bogdan 1, Artur Prusaczyk 2, Izabela Norek 1, Szymon Piątek 3, Jack Gronwald 4, Sabina Karczmarz 2
1 Department of Social Medicine and Public Health, Medical University of Warsaw, Poland; 2 Medical and Diagnostic Centre, Poland; 3 The Maria Sklodowska-Curie National Research Institute of Oncology, Poland; 4 Pomeranian Medical University, Poland
Background. Gynecologic cancers continue to be a significant epidemiological problem worldwide. The best tools to counter the rising trends in morbidity and mortality from these diseases are prevention and early diagnosis. Social marketing is one of the health promotion tools used to change populations’ behaviors and attitudes.
Objectives. The study aimed to characterize and compare the use of social marketing in the prevention of gynecological cancers in Poland and the United States.
Materials and methods. A collective case study analyzing five social campaigns from Poland and five social campaigns from the United States on nongynecological prophylaxis.
Results. There are more materials from American campaigns on the prevention of gynaecological cancer, where more organizations, both state and public, are involved in promotional activities. In Poland, the campaign focus was on singular cancer, whereas American campaigns are designed to include all existing gynaecological cancers. Analysed initiatives usually evoked positive emotions (3 out of 5 Polish campaigns and 4 out of 5 American campaigns), encouraging women to participate in preventive examinations and increasing their knowledge about gynaecological cancers. Two Polish campaigns and one American campaign structured their messages to cause concern. Two Polish campaigns organized free tests or vaccinations, while one American campaign did so. Unlike in the USA, in Poland, public figures were the faces of the campaigns. Gynaecological cancer survivors were often promoting the campaigns in both countries. The most frequently used social media platform was Facebook (62,4% in the USA, and 78,9% in Poland).
Conclusions. The possibilities of implementing social marketing tools in the prevention of gynaecological cancers are still not sufficiently used in both countries. The overall assessment is that the United States are slightly better compared to Polish activities for the use of social marketing in the prevention of gynaecological cancers.
Health care organization in Poland in the light of the refugee crisis related to the military conflict in Ukraine, 2022
Maciej Prusaczyk 1, Tomasz Strzelczyk 1, Artur Prusaczyk 1, Paweł Żuk 1, Monika Golańska 1, Katarzyna Rubinkiewicz 1
1 Medical and Diagnostic Centre, Poland
Background. Poland is witnessing a migration crisis caused by the ongoing war in Ukraine. In addition to housing and necessities, 3.7 million Ukrainians that had taken refuge in Poland must have access to medical care. Estimates show that to meet the needs of an additional million inhabitants, 2,370 doctors would have to be recruited, 7,000 additional consultations and 4,500 extra beds in hospitals will be needed. The accessibility of health services will decline if the healthcare system resources in Poland do not increase immediately and the system is not reorganized.
Objectives. The study aims to propose a strategy for implementing the changes in the Polish health system in response to the Ukrainian refugee crisis.
Materials and methods. The research methodology is based on literature analysis, systematic review and brainstorming. The search and analysis were carried out in electronic databases to identify published studies on healthcare and public health challenges related to refugee crisis.
Results. The proposed strategy for implementing the changes in the Polish health system is based on a quick adaptation of the Polish healthcare system to help refugees and effective use of the resources of the healthcare system. Additionally, the strategy aims to protect the health of Polish citizens by eliminating the problems related to the lack of preventive care and by provisioning care for chronic patients within primary healthcare. The operational objectives and examples of organization-related activities are:
- preparation of medical entities to provide help for refugees,
- development and implementation of the communication system,
- implementation of available digital solutions
- organization of the diagnostic and medical services,
- implementation of changes in the management of medical entities.
Conclusions. The increase in population will mean that the Polish health system will have to evolve into a system suitable for a larger and more diverse population. Reorganization of the system is required to respond to an unavoidable increase in the demand for health services.
Medical coordinator role in Poland in the light of last crisis, 2022
Marika Guzek 1, Małgorzata Kalisz 1, Jolanta Michałowska 1, Anna Kordowska 1, Artur Prusaczyk 1, Magdalena Bogdan 2
1 Medical and Diagnostic Centre, Poland; 2 Department of Social Medicine and Public Health, Medical University of Warsaw, Poland
Background. Role of medical coordinator was introduced in Polish legislation in 2014 and further described in 2015 Rapid Oncology Therapy regulation. The responsibilities of the coordinator were however not defined precisely, which led to limiting coordinator’s role to performing administrative tasks. The importance of this role had increased during pandemic COVID-19.
Objectives. Purpose of the study was to analyse the scope of medical coordinators’ responsibilities in Poland and describe desired skill-set for the role.
Materials and methods. This article is based on a review of the literature on the role and responsibilities of a medical coordinator, and a search instigated in MEDLINE (PubMed). To describe the role of medical coordinator in Poland, relevant legal acts were reviewed.
Results. Medical coordinator is usually an additional role for a healthcare worker (usually nurse, administrative worker or medical secretary), not a standalone position. Their primary task is to ensure the flow of information between the health care provider and a patient at all stages of treatment in order to adapt it to the individual needs of the patient. They take care of the completeness of the documentation, coordinate the appointments for preventive examinations and specialist visits, conduct first interview with a patient, schedule examinations and tests.
Based on Belbin’s team roles, medical coordinator should be a person determined in pursuit of a goal, who can clearly define objectives and prioritize, manage human resources perfectly, and delegate tasks effectively. The crises times show that besides technical skills, the coordinator should also have a number of ‘soft’ skills, including, the ability to resolve conflicts and deal with stress, communication skills, empathy and good manners.
Conclusions. Identification and reinforcement of the role of medical coordinator may have crucial influence on the quality and effectiveness of patients’ care provided in medical facilities especially in times of crisis.
The impact of medical staff competencies on salary calculation in primary care, 2022
Agnieszka Walczuk 1, Mariusz Zamyłko 1, Paweł Żuk 1, Artur Prusaczyk 1, Leszek Średziński 1, Tomasz Włodarczyk 1, Magdalena Bogdan 2
1 Medical and Diagnostic Centre, Poland; 2 Department of Social Medicine and Public Health, Medical University of Warsaw, Poland
Background. Limited financial and infrastructure resources, but above all, lack of staff, and at the same time increasing need and patients’ awareness is the leading problem that the health care sector in Poland is facing. The scientific findings show that efficient and effective patient’s care offering in primary facilities depend largely on the scope and the level of medical staff competencies.
Objectives. This research investigates the issue of assessing the competencies impact on the medical staff salary calculation. These competences were determined by their scope, systematization, core, and the role they might play in patient care.
Materials and methods. The research methodology is based on literature analysis, systematic review and brainstorming carried out in medical facility Medical and Diagnostic Center in Siedlce, Lublin. The search and analysis were carried out in electronic databases to identify published studies on medical staff competencies and their impact on salary calculation.
Results. In the research and analysis process concerning the subject of medical staff competencies, it was found that skills and knowledge are the most vital among other competences. The practical analysis undertaken in medical facility show, that the most important indicators are:
- 85% real use of working time;
- delivery a key medical procedure in 25%;
- delivery a key and technical medical procedure in 65%;
- team work assessment by supervisor;
- implementation of the educational process.
The above-mentioned indicators related to medical staff competencies, should be measured and analyzed in the 6-month time period..
Conclusions. Identification and reinforcement of mentioned competencies as a part of salary calculation may have a crucial influence on managing of the patient care process in primary care.
An overview of factors influencing cancer screening uptake in primary healthcare institutions
Family Medicine & Primary Care Review 2022
W publikacji podsumowano istniejące dowody na temat czynników wpływających na upowszechnienie badań przesiewowych. Lekarze podstawowej opieki zdrowotnej odgrywają istotną rolę w zwiększaniu liczby badań przesiewowych w populacjach i mogą poprawić te wskaźniki dzięki różnorodnym strategiom i interwencjom wdrażanym systemowo. Przedstawiono również oryginalną koncepcję „Ugly Value”, która opisuje czynniki mogące zmniejszyć rozpowszechnienie tych badań.
A. Prusaczyk, P. Żuk, M. Guzek, M. Bogdan, S. Karczmarz